Study On Chinese Medicinal Medication Rules Of Treating Polycystic Ovary Syndrome Based On Real-World Data Mining Of Hospital Information System Ⅱ

3 Discussion

Chinese medicine treats diseases from a holistic perspective, examines symptoms and seeks causes, and is patient-oriented. It is necessary to comprehensively consider the patient's disease itself, emotional factors, psychological factors, and social factors. If a woman's kidney qi is strong, the Tiangui arrives, and the Taichong pulse is strong, then menstruation will come on time; if the kidney qi is insufficient, the source of qi, blood, body fluids and body fluids is insufficient, and the Tiangui is insufficient, then menstruation will be irregular. However, PCOS patients are not caused by kidney deficiency alone. PCOS patients have long-term menstrual disorders, accompanied by clinical manifestations such as obesity, hirsutism, and infertility, which bring serious mental stress to patients. Coupled with the pressure from family and work, PCOS patients are depressed and unable to relax, the seven emotions are unbalanced, and the liver qi is not regulated. Over time, liver depression will cause changes, or liver depression and qi stagnation will hinder the circulation of qi and blood, and menstrual blood will not be distributed; or liver depression will turn into fire, and the heat will damage the yin, and the blood will not flow through the meridians. Therefore, the treatment of this disease should focus on tonifying the kidney and regulating the liver, supplemented by resolving phlegm and removing blood stasis to achieve the expected therapeutic effect.

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3.1 Drug frequency analysis

The frequency of the overall drug use in this study was counted, and 157 Chinese medicines were obtained, with a total frequency of 8,163 times. The high-frequency drugs, such as Cuscuta, Radix Pseudostellariae, Radix Dipsaci, Atractylodes, Dendrobium, Radix Dipsaci, Herba Cistanches, Rhizoma Deer Horns, and Fructus Ligustri Lucidi, have the effects of tonifying the kidney and replenishing essence, nourishing the liver and kidney, strengthening the spleen and drying dampness, and promoting blood circulation and qi circulation. This shows that in the clinical diagnosis and treatment of this disease, it is necessary not only to replenish kidney qi, but also to promote blood circulation, promote qi circulation, and dry dampness.

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Among them, Cuscuta is the drug with the highest frequency of use. Cuscuta is an important gynecological medicine for nourishing the liver and kidney. Modern pharmacology has confirmed that its main active ingredient, Cuscuta flavonoids, can improve ovulation dysfunction and regulate sex hormone secretion [7]. Experiments have also shown that Cuscuta protects PCOS rats by downregulating the expression of ovarian apoptosis proteins and acting on the HPO axis [8]. Radix Pseudostellariae "tonifies Qi but does not promote it, promotes fluid production but does not promote dampness, strengthens the body but does not cling to evil, and replenishes the body without being too strong." Its "clear and tonifying" characteristics are particularly suitable for young women who are in urgent need of nourishment but cannot tolerate warm nourishment [9].
Radix Dipsaci is famous for its "repair of broken bones". It has the effects of promoting blood circulation, nourishing the liver and kidney, strengthening tendons and bones, calming the fetus, and consolidating Chong and Ren meridians. The "Compendium of Materia Medica" states: "It nourishes the liver and kidney, regulates tendons and bones. It is bitter and warm to nourish the kidney, and pungent and warm to nourish the liver. It can promote blood circulation and regulate tendons and bones.
It treats injuries and replenishes deficiencies." It is a commonly used drug in gynecology. Atractylodes macrocephala is good at strengthening the spleen and replenishing Qi. It is an important drug for tonifying the spleen. It can strengthen the spleen, dry dampness and resolve phlegm, so that phlegm is eliminated and the spleen is healthy.

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3.2 Analysis of drug functional properties

The results of this study showed that the nature and flavor of drugs for treating PCOS are mostly sweet and warm, and they mainly belong to the liver, spleen, and kidney meridians. The drug functions are mostly tonic drugs, blood circulation and stasis-removing drugs, and qi-regulating drugs. Sweetness can relieve urgency and replenish deficiency, while warmth can promote qi and yang. This again indicates that PCOS often has a mixture of deficiency and excess, and replenishing deficiency and purging excess throughout the process. Therefore, sweet and warm drugs are often used to replenish the deficiency and purge the excess. From the perspective of drug meridians, the liver meridian has the highest frequency, followed by the spleen and kidney meridians. Master Jiang's preference for the nature and flavor of drugs for treating PCOS is consistent with his characteristics of PCOS diagnosis and treatment.
Traditional Chinese medicine emphasizes that "women are based on blood and liver is congenital". The liver stores blood, regulates qi and smoothes qi. The physiological function of the liver is of great significance to women's menstruation and pregnancy. When liver qi fails to regulate, blood vessels are not smooth, and ovulation disorders and menstrual disorders occur. The kidney governs reproduction and is the congenital foundation. The liver and kidney have the same origin, and storage and drainage are used interchangeably. If the liver qi is not comfortable, the child will be sick and the mother will be affected, resulting in kidney qi deficiency and lack of body fluid, which gradually produces phlegm and dampness. Phlegm and dampness block the uterus, causing sperm retention and ovulation disorders and infertility. Therefore, starting from the theory that kidney controls reproduction, PCOS treatment from the perspective of liver has a certain theoretical basis. In addition, most of the PCOS patients included in this study were young and middle-aged women in their 40s and 70s. Patients of this age group have full liver qi. Under the pressure of work, life, and illness, liver qi is not smooth and qi stagnation turns into fire, or long-term illness will inevitably lead to emotional depression and liver qi discomfort, or even liver stagnation turns into fire. Therefore, drugs for soothing the liver, clearing the liver, and promoting qi and regulating qi are often used, such as Amomum villosum, Cyperus rotundus, Chuanxiong, and dried tangerine peel.

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3.3 Drug association rule analysis

The collected prescriptions were further analyzed by association rules, and 3,942 association rules were obtained. The minimum support was set to 40% and the minimum confidence was set to 90%. Common drug pairs and key drugs based on association rules were obtained, such as Radix Pseudostellariae-Dendrobium, Radix Pseudostellariae-Dipsacus, Semen Cuscutae-Cistanche, and Semen Cuscutae-Pseudostellariae-Dendrobium. All of them are based on the principle of kidney tonification. The essence of this disease is the dysfunction of the liver, spleen, and kidney, which is dominated by "kidney deficiency". By tonifying the kidney yin and kidney yang, the yin and yang of the five internal organs can be replenished, so that the kidney qi is sufficient, and then the spleen qi is healthy and the liver qi is relaxed, so the uterine vessels are smooth and the menstrual blood flows naturally. High-frequency drug pairs such as Radix Pseudostellariae-Cistanche are used to clear and nourish the body, while Cistanche warms the yang and nourishes the kidney. Modern pharmacology shows that Cistanche contains a variety of amino acids required by the human body, such as valine, which can act on the corpus luteum, breast and ovary to help women conceive [10]. High-frequency horn medicines such as Radix Pseudostellariae, Dendrobium officinale, and Dipsacus asper are used together to replenish both yin and yang in the kidney. Pharmacological studies have shown that many Chinese medicines for tonifying the kidney contain endocrine hormone-like effects and can bidirectionally regulate the HPO gonadal axis in women [11].

 

3.4 Analysis of new prescriptions based on cluster analysis

Five groups of candidate new prescriptions were obtained using complex entropy clustering as an algorithm. Group 1: Radix Pseudostellariae, Dipsacus asper, Fructus Ligustri Lucidi, Fructus Mori, Atractylodes macrocephala, Dipsacus asper, Cistanche deserticola, Rubus idaeus, and Deer Horn Frost. Dendrobium officinale, Fructus Ligustri Lucidi, Fructus Mori and other kidney yin tonifying drugs are used heavily, and Cistanche deserticola, Rubus idaeus, Deer Horn Frost and other kidney yang tonifying drugs are used as adjuvants, meaning that yin is sought in yang, so that yin can be helped by yang and the source is inexhaustible.

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Group 2: Radix Pseudostellariae, Fructus Corni, Dipsacus asper, Fructus Mori, Rehmannia glutinosa, and Atractylodes macrocephala. Radix Pseudostellariae, Atractylodes macrocephala, and Chinese yam have the effect of replenishing qi and strengthening the spleen, while parasitic vine, mulberry, and cornus officinalis have the effect of replenishing liver and kidney. When the functions of the liver, spleen, and kidney are coordinated, the body's qi, blood, yin and yang are balanced, and menstrual blood flows on time. Group 3: Eucommia ulmoides, parasitic vine, mulberry, Dipsacus asper, Cistanche deserticola, Cuscuta australis, and Rubus idaeus. The main principle is to replenish kidney yang. The growth and development of follicles depends on the nourishment and moistening of the yin and yang qi in the kidney. The encouragement and promotion of the yang qi in the kidney is the driving force for the discharge of follicles. When kidney yang is weak and the promotion is weak, the growth and development of follicles are slow and cannot be discharged, and PCOS patients have no ovulation. Therefore, during treatment, warm and tonifying kidney yang drugs should be used to promote the growth and development of follicles, encourage the orderly discharge of follicles, regulate menstruation and assist pregnancy. Group 4: Trillium, Pseudostellariae, Cinnamomum cassia, Gleditsia sinensis, Notopterygium incisum, Cuscuta australis, and Deer Horn Frost. On the basis of kidney-tonifying drugs, add products such as Trillium and Gleditsiae to dissolve blood stasis and resolve phlegm. Phlegm and blood stasis are the core pathological factors of PCOS. If phlegm and blood stasis are not dissolved for a long time, it can cause phlegm and blood stasis to bind together, further hindering the circulation of qi and blood. The uterus cannot be nourished or phlegm and blood stasis stagnate in the uterus, resulting in late menstruation, amenorrhea, infertility, etc. Therefore, products that dissolve phlegm and resolve blood stasis should be used in clinical practice. Group 5: Salvia miltiorrhiza, Rose, Paeonia suffruticosa, Gleditsiae, Rubia cordifolia, Coix seeds, Millettia reticulata. Strengthen the spleen and eliminate dampness, and activate blood circulation and regulate menstruation.

Looking at the five groups of new prescriptions, although the prescriptions and drugs are different, they are all based on tonifying the kidney, supplemented by drugs that soothe the liver, strengthen the spleen, remove blood stasis, and resolve phlegm, which reflects the basic pathogenesis of kidney deficiency and phlegm stasis. The treatment should be based on the deficiency and excess of yin and yang in tonifying the kidney, so as to strengthen the yin and yang of the five internal organs, and at the same time, soothe the liver and strengthen the spleen, so that the qi is smooth and the spleen is healthy, and the effect of removing blood stasis and resolving phlegm is achieved, so that the uterine vessels are harmonious, the Chong and Ren meridians are regulated, the menstrual blood flows, and the follicles develop well, so there is a child. Therefore, in clinical application, the new prescription can be added or subtracted, but it is still necessary to adapt to the time, the person, and the place, and treat according to the syndrome differentiation, with emphasis.

In summary, this study selected a multi-center HIS database to explore the real-world TCM treatment of PCOS. Through the results of this study, the core pathogenesis of this disease is kidney deficiency and liver depression. The common clinical syndromes are kidney deficiency and liver depression and liver-kidney yin deficiency. The drugs used are mainly sweet and warm, and the drugs belonging to the liver meridian are mainly used. The commonly used drug pairs, corner drugs and core drug combinations all reflect the treatment methods of tonifying the kidney, soothing the liver, activating blood circulation and resolving phlegm. This study includes 2 research centers, which can reflect the real-world treatment of PCOS to a certain extent. In addition, this study only explored the medication rules of PCOS, and did not analyze its syndrome distribution and prescription dosage. Therefore, in the future, multi-center, large-sample, and in-depth studies are still needed to further verify the results of this study.

 

[References]

[1] WILLIAMS T, MORTADA R, PORTER S. Diagnosis and treatment of polycystic ovary syndrome[J]. Am Fam Physician, 2016, 94 (2): 106-113.
[2] Jiang Tingting. Study on the etiology of polycystic ovary syndrome [J]. Chinese Journal of Family Planning, 2016, 24 (6): 422-427.
[3] TEEDE H, MISSO M, COSTELLO M, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome [J]. Fertil Steril, 2018, 110 (3): 364-379.
[4] Anon. ACOG Practice Bulletin No.194: Polycystic Ovary Syndrome [J]. Obstet Gynecol, 2018, 131 (6): e157-e171.
[5] Sogc Clinical Practice Guideline. No. 362-Ovulation Induction in
polycystic ovary syndrome[J]. J Obstet Gynaecol Can, 2018, 40(7): 978-987.
[6] Endocrinology Group and Guideline Expert Group of the Chinese Society of Obstetrics and Gynecology. Chinese Diagnosis and Treatment Guidelines for Polycystic Ovary Syndrome[J]. Chinese Journal of Obstetrics and Gynecology, 2018, 53(1): 2-6.
[7] Zhao Qianying, Wang Dongcai, Wu Haibin, et al. Effects and Mechanisms of Total Flavonoids from Cuscuta Semen on Serum Thyroid Hormones and Ovulation Disorders in PCOS Rats[J]. Journal of Traditional Chinese Medicine, 2022, 28(5): 30-34, 46.
[8] Zhang Kun, Lv Xiangkun, Jiao Aili, et al. Study on the Mechanism of Total Flavonoids from Cuscuta Semen on Pregnancy Outcome and Th1/Th2 Balance in Rats with Threatened Abortion[J]. Modern Chinese Medicine Research and Practice,
2022, 36 (4): 24-28.
[9] Zang Mingxuan, Hao Tengteng, Wu Yu, et al. Wu Yu's prescription for treating lung adenocarcinoma based on data mining [J]. China Pharmaceutical Industry, 2021, 30 (24): 54-58.
[10] Zhang Xiangyuan, Yu Tongyue, Zhao Linhua. Clinical application and dosage of Cistanche deserticola [J].
Jilin Journal of Traditional Chinese Medicine, 2022, 42 (8): 966-969.
[11] Li Xiufang, Wang Zhongqing, Zhu Lei, et al. Research progress on kidney-tonifying Chinese medicine to improve oxidative stress damage of oocytes in elderly infertile women [J]. World Traditional Chinese Medicine, 2022, 17 (22):
3263-3269.